Medical education in the United States and Canada;: A report to the Carnegie Foundation for the Advancement of Teaching

by Abraham Flexner

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Genres: Science, Medicine

346 pages, Unknown Binding

First published August 10, 2009

About the author

Critical report of American educator Abraham Flexner on American and Canadian medical schools in 1910 resulted in a sweeping reform.

People best know his role in the 20th century of higher education in the United States.

After founding and directing a college-preparatory school in his hometown, Flexner in 1908 published a critical assessment of the state of the American educational system, titled The American College: A Criticism . His work attracted the Carnegie foundation to commission an evaluation in depth into 155 colleges and universities across the United States and Canada. His resultant self-titled Flexner Report , published in 1910, sparked reform in the United States. Flexner also founded the institute for advanced study, which in Princeton brought together some of the greatest minds in history to collaborate on intellectual discovery and research.

Reviews

[Gabrielle · Rating 5 out of 5]

While published in 1910 and certainly reflecting some parts of the times, the book nonetheless provides timeless admonishments against the greed of modern medicine as found by private, for-profit hospitals and greedy insurance despite being much older than both as Flexner emphasizes that medicine and medical education cannot be profit-motivated.

Flexner, at the time, describes and evaluates each medical school found in 1910 with John's Hopkins and U of M - Ann Arbor as close to the ideal as possible. Flexner's report helped eliminate useless, profiteering "medical schools" and helped usher in the high standards and general curriculum that characterize modern medical schools. This report helped catalyze the US into the research powerhouse that it became after Germany's fall from grace. The recommendations of fewer medical schools may seem quaint to modern ears; however, note that at the time, many medical schools were unqualified business ventures interested in turning out as many "physicians" as possible, taking in even those who lacked high school diplomas.

Interestingly, the report also discredits homeopath, chiropractic, eclectic, and osteopath, that were (rightfully) stated as unscientific due to their dogmatism. Interestingly, the first two have since been relegated as pseudoscience with some chiropractic institutions reforming somewhat, and osteopathy has totally reformed, acting in a similar manner as MDs and passing the same state boards, a development that Flexner probably did not see coming as osteopathy's origins were dubious in accuracy.

[Murray · Rating 3 out of 5]

This is not for the general public. Published in 1910, this is required reading by every student of the history of medicine. It has been called by some American historians one of the most influential documents ever produced in the country, and by all measures that is true. It also should be read and understood by everyone who advocates reforming the health care system, because you cannot hope to allay our current problems without understanding how we got to where we are now.

After this report was published one-third of the medical schools in this country closed, including most schools for women and African-Americans. It is true that the practice of scientific medicine was advanced, but we paid dearly with significant trade-offs: The high cost of health care, its inaccessibility to many people, and the lengthy training of physicians were direct consequences of adopting the policies this report advocated.

It should be understood this is anything but an evidence-based treatise. It could never be published today without engendering huge criticism. It is biased (sponsored by the AMA and paid for by its political allies), rants against the suitability of blacks and women becoming physicians and offers no objective data to support its conclusions. Our current system of educating physicians, licensing them, and establishing their hegemony grew out of this report's unprovable assertions unaccompanied by proof of outcome.

[Matthew Noe · Rating 4 out of 5]

This should be required reading - at least the parts about the foundations of medical education established in the early 1900s - for any medical educator or medical librarian. This report colors meded as we know it to this day.

[Dawn Paris · Rating 3 out of 5]

Okay, so I didn't read all of it, but if you're looking for turn-of-the-twentieth century medical school information, this is a nice reference. It's pretty shocking today to read about what some medical schools required of their students (as in, not much but payment of fees), but it must have been really stunning back then, especially if one got the information as filtered by the press. I think some of the details - such as the school whose autopsy area did double duty as a chicken feed lot - could make great story fodder.

Oh, and this kindle edition? Which I spent 99 cents on so I could step away from the computer without having to print? Is okay, but the footnotes show up in the text in the same position as they would have in the physical text, so you have to find where the text resumes after the footnotes. It was worthwhile at that price for my purposes, however, since I did not have time to go hunting around elsewhere.

[Sydney Robertson · Rating 3 out of 5]

In this report, Flexner identifies the ways in which medical education can improve the quality of graduating physicians and their experience in the program. However, it is interesting to see the lack of attention paid to personal patient care, study of humanities: morality and ethics, or the human-to-human interaction between physician and patient.

An interesting read for somebody who wants to know a little more about medical education in America.